Objectives: Over the counter (OTC) medication abuse is an increasing public health concern. We studied the clinical profiles, treatment and prevalence of patients admitted with OTC opiate abuse.

Method: Using a specially designed demographic form, the records of patients admitted to St. Patrick’s Hospital, a 280 bed inpatient mental health and addiction treatment facility in Dublin, with a diagnosis of harmful OTC opiate abuse or opiate dependency as defined in ICD-10 were reviewed retrospectively. All patients diagnosed with OTC opiate abuse (ICD F11.1) or dependency (ICD F11.2) on admission to our centre were included in the study. Patients with a diagnosis of primary illicit opiate misuse were excluded.

Results: Approximately 1% (n=20) of inpatients admitted in a year were diagnosed with OTC opiate abuse. The average daily codeine intake was 261.0 mg per person. Some 75% percent (n=15) of the inpatients experienced OTC opiate withdrawal and were treated with protocol driven withdrawal regimes for an average of 16.10 days. The female: male ratio was nearly 2:1 with an average age of 49.2 years. Patients tended to have co-morbid psychiatric (n=19, 95%), physical (n=17, 85%) and polysubstance (n=13, 65%) illness.

Conclusions: OTC opiate abuse is a significant problem which is largely covert in nature with serious co-morbidity and frequent complications including withdrawal symptoms which require treatment. Results of this study suggest that further research is warranted in this area.